Lord Phillips of Sudbury: My Lords, I thank the committee for the wonderful report that it has produced, and the noble and learned Lord, Lord Mackay of Clashfern, for his chairmanship of it. Beyond and above that, however, I thank the noble Lord, Lord Joffe, for the hugely important role that he has played in bringing this most important of subjects before the House and the public, his indefatigable pursuit of the issues and his sensitivity to views other than his own. I cannot speak too highly of what he has done.

I am a solicitor very long in the tooth. I have had nearly 50 years in the profession. At different times in my career, I have dealt with old and frail people, both in the making of their wills and acting as an executor of their estates, dealing with applications to the Court of Protection. I spent four years as a coroner's assistant, an extremely educative phase of my life, where you come very close to the realities of what we are talking about. I am going to make a few practical observations.

My first is that legislation is never better than a crude instrument. We deceive ourselves if we believe that we can load on to the shoulders of legislation all the refinements and subtleties that we would wish to see in legislation allowing assisted dying. It cannot be that subtle or calibrated.

Modern legislation, I suggest, is honoured in the breach: 14,000 pages of new statute law a year, most of it remaining on the shelf. What is implemented is implemented unevenly and with undue discretion on the part of those enforcing it. How can we be sure that this most complex legislation would have the quality of enforcement and policing without which it could be wholly counterproductive?

The evidence from Oregon and Holland has been presented to us by several speakers as justifying the proposed legislation. I cannot see that. The law was changed in Oregon only in 1998 and in Holland in 2001. The most important aspects of the evidence that I would want to see are the most difficult to find. For example, there is the whole question of undue influence or pressure on old people from relatives, beneficiaries and the like: how does one go about getting evidence for or against that? I suggest to your Lordships' House that we are not remotely in a position of having adequate evidence one way or the other.

The draft Bill itself is full of ambiguities and flexibilities. I do not blame the noble Lord, Lord Joffe, and his helpers for that because we have a cruel choice in legislation. You either have something that is so fixed and certain that it is inflexible or you have something that, being flexible, is full of movement and ambiguity. I pick out a few such key words: "capacity"; "competence"; "fully informed"; "temporary relief". At the heart of the Bill, is the phrase "a few months". "Unbearable suffering" is defined as,

"suffering whether by reason of pain or otherwise".

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There is no suggestion of what "otherwise" that might be. All that would lead to a position that we have seen pursuant to the Abortion Act: specialist firms of doctors offering their services as an assurance to find a way through the complexities to the result that an old person or, more likely, the relatives wanted.

Above all, we cannot have it both ways in the Bill. We cannot liberate the terminally ill suffering unbearable painin the way that, I understand, people wantand simultaneously protect the vulnerable old from abuse by pressure or undue influence. We cannot straddle those dual objectives. There will be the age-old problem of people saying, "I'm a burden on my family. I've had a good life. I can't afford it". That is a commonplace, and we have all seen it. I am afraid that, whether one wishes for it or not, undue influence will be the necessary handmaiden of the Bill, however unintended.

In Oregon, the research by A D Sullivan and others shows that, whereas in 1998 only 12 per cent of those requesting physician-assisted suicide felt themselves to be burdensome, a mere two years later that had risen to 63 per cent. In the 1987 MORI survey annexed to the report, 71 per cent agreed and only 12 per cent disagreed that people permanently dependent on others for medical or nursing care might request euthanasia in order not to be a burden on others. Even among geriatricians, a survey done by the universities of Sheffield and Charleston in 1999 shows that 84 per cent of them believe that legalisation of physician-assisted suicide might put pressure on vulnerable patients to request just that, and 53 per cent feared that the social process of dying and grieving might be undermined.

The balance of harm has not been weighted sufficiently for my practical view in favour of the proposed Bill. Lastly, I would call into my speech the words of the right reverend Prelate the Bishop of Oxford and my noble friend Lord Carlile.

6.12 pm

Lord Ackner: My Lords, I join in the congratulations so elegantly expressed by the noble Lord, Lord Phillips of Sudbury.

I have a clear recollection of the Suicide Bill, because it occurred in 1961, which was the year in which I got silk from Lord Kilmuir. The Bill seemed to be very soundly based. I decided I would look back at the Second Reading debate to see whether there was wisdom to be found there; and I think there is. On 2 March 1961, at col. 261 of the Official Report, Lord Silkin said that, as a result of what was being suggested, society would no longer regard it as its business to preserve life. That seems to indicate that society was rejecting the sanctity of human life, because if such sanctity were maintained, it would be impossible to legislate to make suicide no longer a criminal offence. The Bishop of Carlisle was of the view that it was contrary to law to take one's own life, and he founded that upon the sanctity of human life.

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In the same debate, Lady Wootton of Abinger said:

"The early Christians were, I think, very much disposed to suicide; and perhaps they were so disposed through excessive rationality. They assumed that by an early departure from this life they could escape not only its miseries, but also its temptations, and that they would thus equip themselves with a clean passport to the blessed state of the next world. It was, I think, because of this tendency to favour suicide that St. Augustine felt himself called upon to discourage the practice".[Official Report, 2/3/61; cols. 266-67.]

Lord Denning, not then Master of the Rolls, said that suicide had been a crime for nearly 1,000 years:

"The reason for that law was stated by Blackstone to be founded, as it was, on our religion. The law of England, he said, wisely and religiously decreed that no man had power to destroy life except by commission by God, the author of it".

That was clearly a religious backing to the foundation of suicide being a crime. He went on to say:

"But what about . . . Clause 2 of the Bill, aiding and abetting suicide? If we do away with suicide as a crime, logically we do away with any aiding and abetting, because you cannot aid and abet a crime when it is no longer a crime. Indeed, it is illogical to have this clause in here, but it may be needed".[Official Report, 2/3/61; cols. 262-5.]

However, he pointed out that suicide had never been a crime in Scotland, and said that Scotland had not apparently found it necessary to have any aiding and abetting provision.

Several years before the Bill was passed, Professor Glanville Williams, at whose feet I tried to learn, had written a book entitled The Sanctity of Life and the Criminal Law, in which he said:

"The religious objection is principally the familiar one that killing falls under the ban of the Sixth Commandment. This theocratic morality is, however, no more successful in the present application than in those previously considered. The true translation of the Sixth Commandment is not 'Thou shalt not kill', but 'Thou shalt do no murder', as the Book of Common Prayer has it; and it is only by a stretch of words that a killing with the patient's consent, to relieve him of inexpressible suffering, can morally be described as murder".

Of course there must be safeguards, and these, I submit, have been properly and fully considered by the noble Lord, Lord Joffe.

In conclusion, I ask your Lordships' forgiveness if I leave soon after completing this speech. The lift in my block of flats is out of order, and I have gone down six flights of stairs to get here. It is easier getting down the stairs because, if you do it backwards, the prospect of doing any real injury is remote. Going upstairs, though, requires some assistance, and I have got someone to stand by to assist me, provided that I am not too late. I am much obliged.

6.20 pm

Baroness Morgan of Huyton: My Lords, when people ask what the point of the House of Lords is, we should point to this debate and to the quality of the committee's report. Whatever the eventual outcome of our discussionsI should say that I support a change in the lawthe time is clearly right for this debate. I pay tribute to the noble Lord, Lord Joffe, for bringing forward his Bill.

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We cannot ignore this matter because it is being debated in the country, in the media, in pubs, in churches, at school gates, over the kitchen table and in many families. The public followed the Diane Pretty case in detail day by day and watched its tragic outcome. This is an issue that touches, or will touch, many of us. It is not the preserve of professionals, nor can it be the preserve of those with strong religious beliefs. It is the preserve of all of us.

We have received particularly strong statements from practioners of palliative care and from hospices that their relationships with the terminally ill could be affected. Of course we have to listen to and respect that. But we should recognise with the greatest respect that their views may not be the views of their patients. It is their patients' views that must be paramount. The Bill offers independent choice to those who are denied it at present. Of course we all wish to see palliative care improve in future and hope that the Bill will not be necessary. But the Bill does not deny the improvement in care that we all seek. This is not an either/or situation. This is an issue of independence and equality. It is about an extension of human rights to those who are at present denied them.

I welcome the amendments outlined today by the noble Lord, Lord Joffe. They deal with several concerns raised by the committee. It is clear that a lot more detailed work will be needed to get the Bill right. But in the end the public know in principle what this debate is about. Like many noble Lords, I have received lots of strongly argued letters with passionate views from both sides. Like my noble friend Lady Gibson, I found one particularly poignant and I shall read a section of it. The young woman argues that she has a very cruel choice between starvation or hard suffering and a very unpleasant end. Her other choice is to go abroad with her husband to help her. The reason that she feels unable to do that is her fear of what her husband's legal position would be when he returns. She wrote:

"I cannot plead with you more, to listen to your public. Hear their voices. A change in the law to make assisted dying legal in this country is not only the right decision, but also a necessary step forward, so that people, who often have their dignity taken away from them by their illness, can at least have a dignified death at a time of their choosing. Bring an end to the unnecessary suffering felt by many. Give patients their voices back".

I hope that we can fulfil her wishes so that in future others will not suffer in the same way.